ABSTRACT
Objective: to assess the optimal timing of intervention and post-operative morbidity for acute calculous
Cholecystitis
Study design: cross sectional study
Place and Duration of study: surgical unit Hayatabad Medical Complex Peshawar, from February 2015 to January 2016
Methodology: a total of 110 patients having age range of 20-55 year were included. Patients having common bile duct stones, clinically jaundiced and associated co morbid diseases, were excluded. Patients were divided into two groups having 55 patients in each group. Group A patients underwent early laparoscopic / open cholecystectomy within 72 hours of presentation while group B patients had delayed laparoscopic / open cholecystectomy after 72 hours of presentation. In both the groups laparoscopic cholecystectomy was attempted initially but in difficult cases decision was made to convert to open procedure. Postoperative morbidity of both groups was compared
Results: mean age of the study population was 40.5+2.5 year. Male to female ratio was 1: 8.2. Biliary leak occurred in 1.8% patients in group A and 5.5% in group B. Common bile duct injuries occurred in 1.8% versus 3.6% patients and conversion rate was 3.6% against 12.7% in group A and group B respectively. Hospital stay in group A patients was 2.5 days as compared to 4.5 days in group B. Overall complication rate was 7.2% and 29.1% for groups A and B
Conclusion: early laparoscopic cholecystectomy within 72 hours significantly decreased the conversion rate, postoperative morbidity and the length of hospital stay
ABSTRACT
Abstract: Urethral catheterisation is a common and safe procedure performed routinely. The small size of the urethra in a child necessitates the use of an infant feeding tube (Size 5 to 8 F) for catheterisation. Knotting within the bladder is a rare complication with significant morbidity often necessitating surgical or endoscopic removal. Insertion of an excessive length of tube contributes to coiling and knotting. We report an instance of knotting of an infant feeding tube in the proximal penile urethra of a 4 year-old male child requiring urethrotomy to remove it. Awareness of the risk and proper technique can reduce this complication
ABSTRACT
To determine the sensitivity and specificity of fine needle aspiration cytology [FNAC], by comparing the results with excision biopsy. This observational and comparative study was conducted in Surgical B Ward of Khyber teaching hospital Peshawar, Pakistan from August 2002 to May 2003. A total of 50 women, who had a clinically palpable breast lump were subjected to concurrent FNAC and excision biopsy. Out of 12 malignant lesions on excision biopsy, FNAC correctly diagnosed 9, and 2 were diagnosed suspicious, and the remaining one was misdiagnosed as non malignant. So false negative being 1/12 [8.3%]. Of 38 benign cases on excision biopsy, FNAC diagnosed correctly duct ectasia 3, tuberculosis 2, and galactocele 1, while out of 22 fibroadenoma, FNAC diagnosed 20, and 2 were diagnosed as unsatisfactory. Ten cases diagnosed as fibrocystic disease on excision biopsy, FNAC picked only 6 cases correctly. The one case diagnosed on FNAC as fibrocystic disease, turned out to be malignant on histology. The remaining 4 cases of fibrocystic disease diagnosed on histopathology were either reported as unsatisfactory [3 cases] or suspicious [1 case] on FNAC. The sensitivity and specificity of FNAC was 91.66% and 96.96% respectively. Breast cytology was an effective and rapid method of diagnosis of breast diseases. It helps in deciding which patient needs early open biopsy. A negative cytology does not exclude the possibility of malignancy, as there was a false negative rate of 8.3%